Unlikely but possible. People made the same claims about Lopez and other cases and it turned out to have almost no effect. And in light of this court's variance from past courts, it's unlikely the jurisprudence survives the current composition.

Chief Justice John Roberts is a genius. He saved the reputation of the Supreme Court while simultaneously restricting the Commerce Clause and calling out the Dems for being liars (and now they are loving him for it).
I am impressed.

I wouldn't say he restricted the Commerce Clause, as much made it clear that it doesn't cover economic non-activity as it does economic activity, i.e., the rationale for charging a penalty for opting out of insurance is not justifiable under that power of Congress.

My personal view, a very cynical one, is that many of the laws are deliberately "badly" written so that they can be deliberately "randomly" enforced. Viewed from this vantage point, America is a very sad country. Then there are citizens who are startlingly poorly educated, making the "deliberate randomness" that much easier.

Here's what's absurd about the American health care system....if you go to emergency without insurance and get treated, you're effectivel forcing up the insurance rates of others. This law, by compelling everyone to get insurance, and penalizing those who don't have any, redresses that imbalance.

That said, there's plenty that's just absurd about the way Americans do things. Health care is just one part of it.

It does not control cost. You are correct. And at a time when The United States stands on the verge of a debt induced economic collapse....Obama decides to spend $1,000,000,000,000 on additional health coverage with no cost curbs. The end is near.

It's a loss, Obamacare cuts out competition in healthcare.The American health care system was absurd but at least American's still had a choice in the matter. The American government is forcing everyone to abide to new healthcare or pay a penalty. Even with higher insurance rates the majority of American's pay less than what they will under Obamacare. Obamacare is a recipe for overcrowded hospitals, doctors and nurses with lower paychecks and pensions, and a bureaucratic mess that will cost a fortune on top of our debt. A few of my colleagues who are top paid doctors have already left the country because they can make more money in private firms outside the U.S. Not to mention the ludicrous pork-barrel regulations that have been passed in the other 1,500 pages of a 2,700 page bill.

since when did Americans have real choice in health insurance? health insurance companies are state regulated, and only a small number of companies operate in any given state - so no we don't have much choice. Don't forget also that most Americans get their health insurance through their employer and therefore have essentially one choice - take it or leave it.

We are alone in the industrialized world in employing a profit-driven private insurance system for funding our health care. The result is a fragmented patchwork of coverage, and chronic conflict between generation of returns for shareholders versus taking care of patients.

The fragmentation results in extraordinary inefficiencies, with 31 cents of every health care dollar (totaling $400 billion per year) diverted to overhead, marketing, profit, executive compensation and the imposition of excessive paperwork on providers.

In contrast, Medicare runs on an overhead of under 3 percent. Rather than continuing to funnel our health insurance coverage and processes through these private, profit-driven companies, we should follow the example of much of the developed world and institute a single-payer, simplified mechanism for funding our national health care.

Well, it used to be $15 trillion, but who knows how much of that was froth, and indeed if much of it will be around in 5 years time, but at that point health care costs will be sort of a moot issue, because people will be worrying about much more immediate needs like a slice of bread or a cup of water.

"Construing the commerce clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority."

But one can replace "doing nothing" in this context with "self-insuring". If the ACA had prohibited self-insurance explicitly, would that have passed Robert's Constitutional muster?

A very clever judge can distinguish his way into or out of almost anything.

ACA is a ridiculously distended and unneccessarily complex attempt to evade the fundamental underlying issues facing medical care, the result of gutlessness on one side and unreason on the other. We can't evade them much longer. But I suppose it's better than nothing for now.

You gotta start somewhere. Maybe this will force Republicans to finally have that conversation beyond just shouting down Obamacare...if Obama wins.

So far I've never seen any real, implementable solutions from the right. They seem entirely committed to minimizing individual mandates or even the public provision of health care. Nothing wrong with that. But they should be more honest about their intents, rather than hiding behind cost projections.

True North, Are you not aware of Romney's health plan for Mass.?? Why must this be handled at the federal level? And why spend $1 Trillion now? We have serious debt problem....we will follow Greece path of 50% youth unemployement.

As if the "Tea Party" (for it is they who now own the GOP) were remotely interested in policy. Their stated aim is to undermine and eventually remove Obama from office. Alas, America is still a casualty of its ugly, racist past.

Comparing the United States to Greece is simply comical. Oh, and being the only country in the developed world that does not have Universal Healthcare is a sick joke. It's extraordinary to think that the US is pretty much the ONLY country on earth where people (even when they HAVE health insurance!!) go bankrupt because of healthcare costs and where a large percentage of bankruptcies are due to healthcare. And this in a country where we spent more on war (so called "Defense") than every other country on earth combined.

The rate has not declined in Massachusetts since passage of that state’s health reform bill, as much of the new coverage there is bare bones high deductible policies.

While the personal bankruptcy rate due to medical bills in the rest of the industrialized world is zero, more than 60 percent of such bankruptcies in the United States are related to medical bills; almost 80 percent of those being bankrupted had health insurance prior to illness.

Since the ACA contains no effective cost-control measures, the situation summarized above can be expected to worsen.

Well, I hope that the 50 million-odd beneficiaries of the reforms and their supporters will this time learn to speak with their damn votes (I'm referring to the November elections, of course). And that in the meantime, they'll make it clear to their representatives in Congress that anyone who seeks to undermine the reforms will pay the obvious electoral price for it.

Alas, I won't bet on such a determined stand. As in the past, I expect them to sit on their hands and allow the so-called Tea Party to spread their poisonous, hate-filled, mendacious drivel with a view to repealing the statute as promised by their new best friend, Romney. And after the repeal, I expect them to launch a belated, half-hearted and hopeless rearguard action (think the emergence of the Occupy Movement long after the "Tea Party" had taken over Congress) supposedly aimed at "protecting our healthcare rights".

The beneficiaries of Greek government's spending have been rewarding their leadership for decades...America's beneficiaries of government spending should do the same...at least...until the whole system collapses.

If I understand you correctly, you're suggesting that policies such as Obama's healthcare reforms lead invariably to Greek-style bankruptcy. You need not worry, my dear friend: America's Military-Industrial-Complex (you may wish to add the word "Congressional" to the equation as Eisenhower originally intended) is already seeing to that.

I agree, except that the "payout" in this case comes in form of covering those ruinously expensive medical bill in the event of a serious illness, which, in my view, is unquantifiably greater than any sum of money you care to mention.

Well, much of the cost of those medical bills would have been passed on to others. Nor would the elusive homo economicus make that decision based on the worst-case scenario. I'm sure many who come out an the wrong end of that bet wish they had purchased health insurance, but that doesn't mean that their decision was wrong according to classical economics.

First, although I concede that this has an economic dimension (not least from Mr Obama's own stated justifications), it isn't mainly about economics - any more than educating our kids in the public sector can be so described, even though this is clearly also an economic investment. Healthcare is primarily about giving some measure of dignity to those who have to make a choice between heating their homes and paying for medicines - and much else besides. Thus, your reference to "classical economics" is largely irrelevant to the discourse, in my view.

As for passing medical bills to others, have you ever owned a car, a home or its contents, for example? I ask because your premiums are invariably determined by how reckless (or fraudulent) other insured people have been (or indeed, are likely to be).

I disagree that it isn't mainly about economics. Most forms of insurance, including health insurance, have a strong macroeconomic benefit (and I think this is far more relevant for policymaking than providing dignity). Spreading risk frees capital for other uses.

However, macroeconomic efficiency is not necessarily microeconomic efficiency. This brings me back to my initial point: while ACA is beneficial for the system as a whole, the majority of those who are currently uninsured (assuming they're the 50 million you were referring to) do not stand to benefit from it.

The concepts you refer to seem more appropriate to a first-year undergraduate Economics class, my friend, and I have neither the expertise nor the will to discuss them with you. What really concerns me is that a country that spends more on healthcare per capita than any of its competitors is unable to provide it to 50 million (roughly 15 percent) of its citizens. Even on your chosen terms, that seems quite scandalously wasteful to me. And that, as I understand it, is what Mr Obama is attempting to address - and a very brave man he is too, given the obvious political risks.

Dow dropped 100 the moment the decision was announced. I thought this was supposed to be a big handout to corporations. I thought it was deficit neutral and even provided economic stimulus. There are very good arguments for universal health care. Economic growth is not one of them.

Actually economic growth may well be served by universal health care. There are many many Americans locked into dead end jobs in dead end industries in dead end towns (and even in dead end marriages) because they are scared to death of losing health care. Free them from that fear, and free their employers (current and potential) from the burden of nursing their flock, and the economy as a whole has every reason to become more flexible, robust, and dynamic.

It’s interesting to see the sacred (right wing middle class American conservative values) cows died one by one. Cow # 1: Wealth transfer: The wealth of this Nation has been transferred; the Middle East is booming. Can’t wait to eat at the McDonalds in Dubai! Cow # 2: National Health Care: We now have the prelude to a socialist medical system. The President is right; you shouldn’t be ruined financially if you get sick. Cow # 3: No Taxes increases: Taxes will go up to pay for everything we have done for the past 12 years. America will not be allowed to die from tax anemia. The TEA in tea party stands for taxed enough already. We are going to be taxed more and a lot sooner than most people expect. The sooner we get off paper money the easier it will be to tax everyone at the pre-determined international rate. Will there be blood in the streets? Hell No!! Must individuals aren’t strong enough to live without 4GB’s of data per month. Very few individuals are able to grow their own food. So we just take it and move on.

"Federal Government's position on core individual mandate was held wrong on all three counts."

Incorrect. The Government's position in litigation was to argue that the payment was a tax. To verify this, read Part III-C of the opinion, or page 17 of the joint dissent, or listen to the oral arguments. Best yet: read the title of Part II of the Government's Supreme Court brief, entitled "“THE MINIMUM
COVERAGE PROVISION IS INDEPENDENTLY AUTHORIZED BY
CONGRESS’S TAXING POWER.” Pretty clear, eh? All are available on the Supreme Court's website for your convenience.

Your concern for the government's unaccepted arguments belies a lack of understanding about how cases are litigation. Parties always throw multiple, often conflicting arguments at the court to give themselves the best chance to win. That's what the government did, and they were successful.

Harping on the lost arguments even though they won big time is like a football coach bragging about stopping his opponent's rushing attack after giving up 1000 yards of passing and losing by 70 points. You, uh, sure showed them.

If uninsured person gets in car accident, who do you expect to pick up the bill? The hospital, the state, or the federal govt? If you expect the uninsured person to pay out of pocket, consider that this is what we have today and it has been a disaster. The hospital and the state pick up the tab, at even HIGHER cost. Which brings us to

B) ADMINISTRATIVE COST

Our administrative cost numbers are embarrassing compared to that of other 1st world economies.

C) SERVICE COST

Rapid privatization can be a benefit and a curse. It is beneficial when competition leads to better innovation, etc. It is curse when hospitals HAVE TO use expensive services to cover losses.

D) LIFESTYLE COST

Obesity IS 5 to 10 percent of health care dollars.

Lifestyle choices -- not genetic predispositions or car accidents -- are expensive. Should you pay less for insurance if you exercise and eat well?

For reasons A+B+C I support this bill.
For reason D, I think we have more much work to do.

"Lied through its teeth" implies that Obama intended to make it a tax in the first place. I don't think that's the case, I'm fairly certain that he intended for it not to be a tax all along. I also don't think he expected it to get a legitimate constitutional challenge (and most lawyers and legal academics thought the same back then).

But Donald Verilli (who isn't Obama) decided several years later, when confronted with the pleadings and briefs filed by opponents, thought that the tax angle was a good strategy. Even he didn't find it as important, as he put most of the weight behind his Commerce Clause and other arguments.Turned out that it survived as a tax. But that has absolutely no bearing in whether Obama thought it was a tax back when he first proposed it.

These things happen every single day in the world of litigation. Whether it be a Fortune 500 corporation's manager defending a defensive tactic to a hostile takeover bid, or an 60 year old executrix defending her distribution of her recently-deceased 90 year old mother's estate property, it happens every day.

The reason that healthcare costs continue going up is the expensive and inefficient U.S. healthcare delivery system. The consequences of the fee-for-service model put an unnecessary financial burden on patients and employers and raise the overall cost of healthcare. Read a recent blog by Bob Fabbio about healthcare spending in the US, http://blog.whiteglove.com/what-does-2-trillion-buy-how-about-our-nation...

My hat is off to one of the DiA bloggers, WW for this, posted elsewhere last night. I sincerely hope that he put everything he had on this result at Intrade last night, and can buy that healthcare he's wanted.....

Today is a historic day for the U.S. Supreme Court; Chief Justice Roberts has transformed the Court from a Kennedy Court to a Roberts Court. Roberts is a charming, highly intelligent and ambitious man. Expect him to lead the Court, not follow it.

1. If a poor person can not afford the insurance, who will pay for it?
2. If put in jail to rotten, who will defend him?
3. So all the fuss about Citizens United about the freedom of people and companies to use their money however they want, is now going to end, since the court ruled with the left?

1. You ... assuming you are not also poor, and you pay your taxes.
2. A court appointed attorney paid by the tax payer. Since we pay for lawyers to represent the poor, what is the big fuss against also paying for their health insurance. If we don't pay for their health insurance, we will have to pay for their emergency care visits. There is no free lunch for the taxpayer.
3. That doesn't make any sense. The mandate is not a leftist idea. It was proposed by Republicans in the 90s as an answer to Clinton's European style health care program (HillaryCare). Republicans were for it before the were against it. I bet the Iron Lady would have been for it, and stuck with it because she is a real conservative, unlike like US Republicans.